Percutaneous transluminal angioplasty was performed successfully in five of six patients with complete iliac artery occlusion. All of the patients were at high risk because of various co-existing diseases. The length of occlusion ranged from 3.0 cm to 12.0 cm. No significant complications requiring surgery occurred during or after the procedures. Follow-up of patients revealed that the vessels were still patent after 3-22 months. Percutaneous transluminal angioplasty of totally occluded iliac arteries may represent the therapy of first choice even in the high-risk group.